The legal framework for hospital financing shapes the basic economic conditions in which hospitals operate. A key principle here is so-called dual hospital financing. A distinction is made between investment costs and operating costs: The investment costs as well as their funding are the responsibility of the federal states, although in this respect some special features apply to the MHH as a university hospital. The ongoing operating costs of a hospital are financed via the remuneration for the hospital treatments provided. Depending on the patient's insurance status, the respective treatment remuneration is billed to the statutory health insurance company, a private health insurance company or directly to the patient.

Differences between the service provider and the payer can arise in many respects, particularly in the area of billing inpatient flat rates per case to statutory or private payers. Here, the Legal Administrative Unit advises the specialized departments on legal matters as required and conducts any necessary legal proceedings to enforce the interests of MHH.

The most important legal regulations in the area of hospital financing are the Hospital Financing Act(KHG), the Hospital Remuneration Act(KHEntgG) and the German Social Code Book V (SGB V).